Healthcare Provider Details

I. General information

NPI: 1386768554
Provider Name (Legal Business Name): PHYSIOTHERAPY ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 07/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1044 MANGROVE AVE
CHICO CA
95926-3509
US

IV. Provider business mailing address

1044 MANGROVE AVE
CHICO CA
95926-3509
US

V. Phone/Fax

Practice location:
  • Phone: 530-343-1908
  • Fax: 530-343-6336
Mailing address:
  • Phone: 530-343-1908
  • Fax: 530-343-6336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROB ZIGENFUS
Title or Position: CONTRACTING
Credential:
Phone: 901-685-7227